Nasal Surgery & Contouring
“Got a nose for beauty? Get a beautiful nose.”
Rhinoplasty, or surgery to reshape the nose, is one of the most common of all plastic surgery procedures. Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may also correct a birth defect or injury, or help relieve some breathing problems.
Rhinoplasty can be performed to meet aesthetic goals or for reconstructive purposes-to correct birth defects or breathing problems.
Age may also be a consideration. Dr. Guy prefers not to operate on teenagers until after they've completed their growth spurt-around 14 or 15 for girls, a bit later for boys. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want.
Reshape nose by reducing or increasing size, removing hump, changing shape of tip or bridge, narrowing span of nostrils, or changing angle between nose and upper lip. May also relieve some breathing problems. (May be covered by insurance.)
1 to 2 hours or more.
Local with sedation, or general.
Temporary swelling, bruising around eyes, nose and headaches. Some
bleeding and stiffness.
Infection. Small burst blood vessels resulting in tiny, permanent red spots. Incomplete improvement, requiring additional surgery.
Back to work: 1 to 2 weeks.
More strenuous activities: 2 to 3 weeks.
Avoid hitting nose or sunburn: 8 weeks.
Final appearance: 1 year or more.
Duration of Results:
Consultation & Preparation
In your initial consultation, Dr. Guy will ask what you'd like your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you. She will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.
Dr. Guy will also explain the techniques and anesthesia she will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Be sure to tell Dr. Guy if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform Dr. Guy if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; and if you smoke.
Dr. Guy will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly.
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and Dr. Guy prefer. With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
The Plastic Surgery
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. Finally, the skin is redraped over the new framework.
Nasal contouring is performed from within the nose, making the incision inside the nostrils. Other times it is an "open" procedure, especially in more complicated cases where a small incision is made across the columella, the vertical strip of tissue separating the nostrils. Your nose can be built up or reduced by adjusting its supporting structures. Adjustments can also be made to improve your nasal airway for breathing problems.
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
Recovery & Results
After surgery-particularly during the first twenty-four hours-your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication prescribed by Dr. Guy. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.
You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. Applying cold compresses will reduce this swelling and make you feel a bit better. In any case, you'll feel a lot better than you look. Most of the swelling and bruising should disappear within two weeks or so. (Some subtle swelling-unnoticeable to anyone but you and Dr. Guy-will remain for several months.)
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Dr. Guy will probably ask you not to blow your nose for a week or so, while the tissues heal. Healing is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one or, occasionally, two weeks, all dressings, splints, and stitches should be removed.
Most rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery. It will be several weeks, however, before you're entirely up to speed.
Dr. Guy will give you more specific guidelines for gradually resuming your normal activities. They're likely to include these suggestions: Avoid strenuous activity (jogging, swimming, bending, sexual relations-any activity that increases your blood pressure) for two to three weeks. Avoid hitting or rubbing your nose, or getting it sunburned, for eight weeks. Be gentle when washing your face and hair or using cosmetics.
You can wear contact lenses as soon as you feel like it, but glasses are another story. Once the splint is off, they'll have to be taped to your forehead or propped on your cheeks for another six to seven weeks, until your nose is completely healed.